A former colleague of Lucy Letby has told how nursing staff were "surprised" by how "very poorly" a previously stable baby became on her 100 days birthday.
Ms Letby is accused of attempting to murder the premature girl, referred to as Child G, three times at the Countess of Chester Hospital in September 2015.
She denies murdering seven babies and attempting to murder 10 others.
The colleague told Manchester Crown Court the baby had deteriorated.
In a statement read to the jury, the nurse, who cannot be named for legal reasons, said there had been a celebration to mark Child G's 100 day birthday, with cake and balloons.
She said: "I remember this day as [Child G] was 100 days old.
"We celebrate this birthday as it is seen as a milestone. We baked a cake and there was balloons around the cot side.
"She was very poorly that day, it surprised me and staff as prior to 7 September [Child G] was stable."
The court has heard the baby projectile vomited after 02:00 BST over that night shift and her abdomen appeared "purple and distended".
Her oxygen levels dropped and she stopped breathing several times over the next few hours before she responded to breathing support on ventilation, the jury was told.
The prosecution alleges Ms Letby, originally of Hereford, overfed Child G with milk through a nasogastric tube or injected air into the same tube.
Ms Letby is said to have made two further attempts to murder the girl on 21 September.
The jury has previously been told the baby survived but suffered irreversible brain damage and was left with disabilities including quadriplegic cerebral palsy.
Ms Letby is charged with murdering seven babies and attempting to murder 10 others between 2015 and 2016.
The 32-year-old denies 22 charges.
The trial continues.
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